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Bowel Incontinence
  • Actual
  • Risk for (Potential)

Related To: [Check those that apply]
Neuromuscular problems:

  • Stroke
  • Multiple sclerosis
  • Diabetes
  • Dementia
  • Nerve trauma

Musculoskeletal problems:

  • Pelvic floor relaxation
  • Nerve trauma
  • Damage to sphincters
  • Radiation
  • Infection

As evidenced by: [Check those that apply]

  • Involuntary passage of stool
  • Cramping/abdominal pain
  • Hyperactive bowel sounds
  • Others

Patient’s Diagnosis: –
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Objective/Expected Outcome;The patient will:

  • Report decreased episodes of bowel incontinence.
  • Others

Nursing Interventions Scientific Rationale
Assess patient's level of anxiety. There is a wide range of normal for bowel elimination; some patients have two bowel movements per day, whereas others may have a bowel movement as infrequently as every third or fourth day.
Perform manual check for fecal impaction. When patient has a fecal impaction (hard, dry stool that cannot be expelled normally), liquid stool may leak past the impaction.
Assess whether current medications or treatments may be contributing to bowel incontinence. Hyperosmolar tube feedings, bowel preparation agents, some chemotherapeutic agents, and certain antibiotic agents may cause explosive diarrhea that the patient cannot control.
Assist in preparing patient for diagnostic measures. To determine cause(s) of bowel incontinence.
Assess degree to which patient's daily activities are altered by bowel incontinence. Patients may restrict their own activity or become isolated from work, family, and friends because they fear odor and embarrassment.
Assess use of diapers, sanitary napkins, incontinence briefs, fecal collection devices, and underpads. Patients or caregivers may substitute familiar products (i.e., sanitary napkins) for more appropriate incontinence products out of ignorance or embarrassment.
Assess perineal skin integrity. Stool can cause chemical irritation to the skin, which may be exacerbated by the use of diapers, incontinence briefs, and underpads.
Ensure fluid intake of at least 3000 ml per day, unless contraindicated. Moist stool moves through the bowel more easily than hard, dry stool and prevents impaction.
Provide high-fiber diet under the direction of a dietitian, unless contraindicated. Fiber aids in bowel elimination because it is insoluble and absorbs fluid as the stool passes through the bowel; this creates bulk. Bulky stool stimulates peristalsis and expulsion of stool from the bowel.
Encourage mobility or exercise if tolerated. This enhances gravity, stimulates peristalsis, and aids in bowel evacuation.

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